Frequently Asked Questions

Most commercial payers (BCBSTX, UHC, Aetna, Cigna) take 60–120 days. Medicaid via TMHP can take 90–180 days. MCOs (Superior, Molina, Driscoll) vary from 30–90 days after TMHP approval. Be patient — this process takes months. We submit all 8 simultaneously and follow up bi-weekly so nothing stalls. You'll always know where things stand via your client portal.

Solo plans include 25 claims/month; Starter includes 50; Growth and Pro include 75; Premier includes 100. We submit through Availity (and Optum for UHC if you choose). Additional claims beyond your included amount are $2.40 each. Scared of submitting claims yourself? That's completely normal. Many new providers are terrified of getting it wrong. We either train you step-by-step or handle it entirely — your choice. Getting paid is the most important part, and we make sure it works from day one.

Availity is a free multi-payer portal for eligibility verification, claims submission, and remittance. Most of our 8 payers can be accessed through Availity at no cost. The exception is UHC — Availity can process UHC claims for ~$25/month, or you can use Optum's portal directly for free. We set up whichever option you prefer.

Yes, always. We credential under YOUR NPI and tax ID. Unlike Headway, Alma, or Grow Therapy, your panel contracts belong to you permanently. If you ever stop working with us, you keep everything you've built — your NPI, your CAQH, your contracts, your patients.

Yes — this is what we recommend. Continue seeing patients on the platform while we credential you under your own NPI. As each panel approves, transition those clients. Most providers run both in parallel for 3–6 months, then leave the platform once all panels are active.

No — LPC-Associates, LMSWs, and other associate/pre-licensed providers cannot be independently credentialed with insurance payers. Insurance companies require full, independent licensure. However, associates can be added to a group practice roster and bill under their LPC-S supervisor's credentials. Contact us to learn how this works within our Starter, Growth, or Pro plans.

Absolutely — new graduates are exactly who we built this for. You don't need to understand CAQH, NPI, PECOS, or Availity before starting. We handle everything. Your free business consultation covers entity structure, malpractice, and revenue planning. Then we build your entire administrative infrastructure from scratch and train you on billing — or submit claims for you.

Denials are uncommon but happen — typically due to a payer closing their panel or documentation gaps. We identify the reason, correct fixable issues, and resubmit. If a panel is genuinely closed, we advise on the appeal process and timing for the next enrollment window.

Type 1 is your individual provider NPI — permanent and personal. Type 2 is a group/organizational NPI for billing as a practice entity (LLC/PLLC). If you hire staff and bill under a group name, you need both. We set up Type 2 as part of Starter and Growth plans.

Texas Medicaid is managed through MCOs like Superior, Molina, and Driscoll. But first you must enroll with TMHP — the state's fee-for-service gateway. Once in TMHP, MCOs can verify your enrollment and contract with you. We handle the entire sequence: TMHP first, then all three MCOs simultaneously.

UHC uses Optum as their claims submission platform. We set up your UHC credentialing, then configure either Optum (free) or Availity (~$25/mo for UHC claims) based on your preference. We also set up your UHC Provider Portal for eligibility checks and remittance. It's one of the more complex setups — another reason providers come to us instead of doing it alone.

No, unused claims do not roll over to the next month. Solo plans include 25 claims/month; Starter includes 50; Growth and Pro include 75; Premier includes 100. Additional claims beyond your monthly allocation are billed at $2.40 per submission.

SimplePractice is our primary training platform, but we also support TherapyNotes, Jane App, and other common EHR systems. If you haven't chosen an EHR yet, we'll recommend the best option during your free consultation.

After your 6-month credentialing phase, you transition to Growth & Operations (starting at $149/mo for solo). This includes: continued claims submission (same monthly limit), CAQH re-attestation every 120 days, license/malpractice tracking, re-credentialing, Availity/Optum management, client portal access, and SimplePractice support. We don't disappear — we become part of your practice's operational infrastructure.

Associates cannot be independently credentialed, but they can be added to your group roster and bill under their LPC-S supervisor. We handle the roster setup, PECOS reassignment, and EHR configuration so supervised associates can see insured patients properly within your group.

After your free consultation, you'll complete our secure online intake form. You'll need: active Texas professional license, malpractice insurance certificate, CV/resume, NPI number (or we register one), diploma/degree certificates, DEA certificate (if applicable), EIN/tax ID, W-9, and professional references. Don't worry if you're missing items — we guide you through everything.

Yes. All documents are stored in HIPAA-compliant cloud storage with a signed BAA. Consultations via HIPAA-edition Zoom. Claims submitted through secure Availity connections. Your data privacy and security are non-negotiable.

Yes — our services are specifically designed for behavioral health professionals: LPCs, LCSWs, psychologists, psychiatrists, PMHNPs, and other mental health providers in Texas. Our expertise, payer relationships, and processes are optimized for behavioral health credentialing and billing.

Pro plans start at $2,299/mo for up to 15 providers, Premier at $2,749/mo for up to 20. Custom pricing for 21+. All providers in the tier get credentialed with all 8 payers. Contact us for a custom quote.

Because credentialing takes time — and that's not us being slow. TMHP can take up to 60 days to process enrollment. UHC takes up to 45 days once they have a complete application. Superior averages 90 days. BCBSTX's CAQH review alone averages 8–10 days before they even start. We need 6 months to get you fully credentialed across all 8 payers. After that, you go month-to-month at the lower maintenance rate with 30 days cancellation.

CAQH ProView is a centralized database where providers store their credentials. Most payers pull directly from CAQH instead of requiring separate applications. The catch: you must re-attest every 120 days or your profile goes "expired" — which can freeze payments across all your payers simultaneously. We build your CAQH profile, authorize each payer to access it, and manage every 120-day re-attestation cycle automatically.

Yes! Our portal includes a Claim Request system. You fill in the patient info, payer, CPT codes, and date of service — we process it through Availity or Optum within 2 business days. You can track every request's status in real time.

RCM companies typically charge 3–10% of your collections — forever. For a provider collecting $15,000/month, that's $450–$1,500/month with no end date. We charge a flat monthly fee with included claims. After Month 6, your rate drops. No percentage of collections, ever.

Denial follow-up and appeals are available as an add-on at $15 per claim worked. Credentialing appeals (if a payer denies your network application) are $150 per event. Most providers rarely need these, but they're there when you do.

Your portal is a full credentialing command center: live dashboard showing every case status, credential compliance tracking with automated expiration alerts, claim request system, secure document vault, activity logs, and notifications. Group practices get multi-user access with separate logins for owners and clinicians.

If you're within your tier limit, just let us know — no extra charge. If you need to exceed your cap, additional clinicians are $125/month during Months 1–6 and $60/month during maintenance. We handle the roster updates with all 8 payers.

Yes — there's a built-in Feedback section in your portal where you can submit feature requests, report issues, or ask questions. We review every submission and you'll be notified when your feedback is addressed.

Your credentials, NPI, CAQH profile, and payer contracts belong to you — always. Upon cancellation, we transfer all applications in progress and provide copies of all documents. Your portal stays active for 30 days after your last billing date.